Specialist Tips - Lumpectomy Closure ($5 one-off payment)
- Abbie Tipler
- Mar 11
- 2 min read
This post is about using a slip knot instead of a surgeons knot.
A slip knot can be used in place of a surgeons knot in ANY scenario. The great news about this, is that you can get lots of practice before you really need to use it.
When you need a slip knot, you really need it; and without knowing the technique you end up frustrated and tying yourself in 'knots' (haha that is about as clever as surgeon's get).
Therefore, I encourage you to practice the slip knot at the start of EVERY suture line (desexing is perfect), so that you are competent in performing the technique when needed.
The technique is shown in the video, but to summarise.
tie a square knot (single throw followed by a single throw)
pull towards you on the long end. Give yourself plenty of short end to play with (as it gets shorter as you pull). When you do this, the suture will flip and you will see a D-shape (see video)
snug down the knot with your needle drivers into the position you want (you can slightly tighten by pulling on short end, but if you fully pull on the short end it locks)
when in position, pull on short end as well, away from the long end (horizontal - parallel to your incision).
follow with 3-4 single throws
If this is not working for you, read this - Common mistakes include:
Not leaving enough of a short end (leave more than usual)
Accidentally pulling on the short end as you are pulling on the long end to create your D shape. This will prematurely lock the whole thing and you will be confused as to why. It is because you were not watching your hand guiding the needle drivers attached to the short end
The slip knot is especially useful for bringing the skin edges together so that when you place your subcutaneous and skin sutures there is no tension, which is obviously important for uneventful healing. Good luck!
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